Deferasirox 360mg Granules
WARNING: This drug may cause kidney problems. Some people have needed dialysis. Sometimes, these kidney problems have been deadly. The risk of kidney problems may be higher if you already have kidney problems or other health problems. You will need to have your kidney function checked as you have been told by your doctor. If you have questions, talk with your doctor.If you are dehydrated or are taking any drugs that can raise the chance of kidney problems, talk with your doctor. There are many drugs that can raise the chance of kidney problems. Ask your doctor or pharmacist if you are not sure.This drug may cause liver problems. Sometimes, this has been deadly. The risk of liver problems may be higher if you are older than 55 years or if you already have liver problems or other health problems. You will need to have your liver function checked as you have been told by your doctor. If you have questions, talk with your doctor.If you have kidney or liver problems, talk with your doctor. This drug may need to be avoided or the dose may need to be changed with certain types of kidney or liver problems.This drug may raise the chance of severe and sometimes deadly stomach or bowel problems like ulcers or bleeding. The risk is greater in older people, and in people who have had stomach or bowel ulcers or bleeding before. These problems may occur without warning signs. @ COMMON USES: It is used to get rid of iron when too much is in the body.
Drug Class
Chelating agent
Pharmacologic Class
Iron chelator
Pregnancy Category
Not available (Risk Summary: May cause fetal harm)
FDA Approved
Mar 2015
DEA Schedule
Not Controlled
Overview
What is this medicine?
Deferasirox is a medicine used to remove extra iron from your body. This extra iron can build up from frequent blood transfusions or certain blood disorders, and it can harm your organs. Deferasirox works by binding to the iron, allowing your body to get rid of it. The granules are meant to be sprinkled on soft food and taken once a day.
How to Use This Medicine
Taking Your Medication Correctly
To get the most benefit from your medication, follow your doctor's instructions carefully. Read all the information provided with your prescription and follow the instructions closely. Take your medication on an empty stomach or with a light meal. To make it easier to take, sprinkle the granules onto a small amount of soft food, such as yogurt or applesauce. Swallow the mixture immediately, and do not store it for later use. Establish a routine by taking your medication at the same time every day. Continue taking your medication as directed by your doctor or healthcare provider, even if you start feeling well.
Storing and Disposing of Your Medication
Store your medication at room temperature in a dry place, avoiding the bathroom. Keep all medications in a safe location, out of the reach of children and pets. Dispose of unused or expired medications properly. Do not flush them down the toilet or pour them down the drain unless instructed to do so. If you have questions about the best way to dispose of your medication, consult your pharmacist. You may also want to check if there are drug take-back programs available in your area.
What to Do If You Miss a Dose
If you miss a dose, take it as soon as you remember. However, if it's close to the time for your next scheduled dose, skip the missed dose and resume your regular dosing schedule. Do not take two doses at the same time or take extra doses to make up for the missed one.
To get the most benefit from your medication, follow your doctor's instructions carefully. Read all the information provided with your prescription and follow the instructions closely. Take your medication on an empty stomach or with a light meal. To make it easier to take, sprinkle the granules onto a small amount of soft food, such as yogurt or applesauce. Swallow the mixture immediately, and do not store it for later use. Establish a routine by taking your medication at the same time every day. Continue taking your medication as directed by your doctor or healthcare provider, even if you start feeling well.
Storing and Disposing of Your Medication
Store your medication at room temperature in a dry place, avoiding the bathroom. Keep all medications in a safe location, out of the reach of children and pets. Dispose of unused or expired medications properly. Do not flush them down the toilet or pour them down the drain unless instructed to do so. If you have questions about the best way to dispose of your medication, consult your pharmacist. You may also want to check if there are drug take-back programs available in your area.
What to Do If You Miss a Dose
If you miss a dose, take it as soon as you remember. However, if it's close to the time for your next scheduled dose, skip the missed dose and resume your regular dosing schedule. Do not take two doses at the same time or take extra doses to make up for the missed one.
Lifestyle & Tips
- Take deferasirox granules once daily, preferably at the same time each day.
- Sprinkle the entire dose on a small amount of soft food (e.g., applesauce, yogurt, pudding, oatmeal) and consume immediately. Do not chew the granules.
- Do not sprinkle on hot foods.
- Do not mix with carbonated beverages.
- Do not swallow the granules whole.
- Maintain good hydration.
- Avoid aluminum-containing antacids (e.g., Maalox, Mylanta) as they can interfere with deferasirox absorption.
- Regular blood tests and doctor visits are crucial to monitor the medication's effectiveness and potential side effects.
Available Forms & Alternatives
Available Strengths:
- Deferasirox 90mg Tablets
- Deferasirox 360mg Tablets
- Deferasirox 125mg Tablets For Susp
- Deferasirox 500mg Tablets For Susp
- Deferasirox 250mg Tablets For Susp
- Deferasirox 180mg Tablets
- Deferasirox 90mg Oral Granules
- Deferasirox 180mg Granules
- Deferasirox 360mg Granules
- Deferasirox 180mg Granules
- Deferasirox 360mg Granules
- Deferasirox 90mg Oral Granules
Dosing & Administration
Adult Dosing
Standard Dose:
Initial dose varies by indication and patient weight. For transfusional iron overload: 20 mg/kg/day. For non-transfusion-dependent thalassemia (NTDT) syndromes: 10 mg/kg/day. Administer once daily on an empty stomach or with a light meal.
Dose Range:
10 - 40 mg
Condition-Specific Dosing:
transfusionalIronOverload:
Initial 20 mg/kg/day. May increase to 30 mg/kg/day or 40 mg/kg/day based on serum ferritin trends and patient tolerance. Max 40 mg/kg/day.
NTDT:
Initial 10 mg/kg/day. May increase to 20 mg/kg/day based on serum ferritin trends and patient tolerance. Max 20 mg/kg/day.
Pediatric Dosing
Neonatal:
Not established
Infant:
Not established for infants <2 years old for transfusional iron overload, or <10 years old for NTDT.
Child:
For transfusional iron overload: âĨ2 years old, initial 20 mg/kg/day. For NTDT: âĨ10 years old, initial 10 mg/kg/day. Dosing adjusted based on weight and response, similar to adult guidelines.
Adolescent:
Dosing similar to adult guidelines based on indication and weight.
Dose Adjustments
Renal Impairment:
Mild:
Initial dose reduction may be considered (e.g., 10 mg/kg/day for transfusional iron overload). Monitor renal function closely.
Moderate:
Initial dose reduction (e.g., 10 mg/kg/day for transfusional iron overload). Avoid if creatinine clearance <40 mL/min or serum creatinine >2 times age-appropriate upper limit of normal. Monitor renal function closely.
Severe:
Contraindicated in patients with creatinine clearance <10 mL/min or severe renal impairment.
Dialysis:
Not recommended for patients on dialysis.
Hepatic Impairment:
Mild:
No initial dose adjustment required. Monitor liver function closely.
Moderate:
Reduce initial dose by 50% (e.g., 10 mg/kg/day for transfusional iron overload). Avoid if Child-Pugh Class B or C. Monitor liver function closely.
Severe:
Contraindicated in patients with severe hepatic impairment (Child-Pugh Class C).
Pharmacology
Mechanism of Action
Deferasirox is an orally active chelator that is highly selective for iron. It binds to iron with high affinity in a 2:1 ratio (two molecules of deferasirox to one atom of iron), forming a stable, soluble complex that is then excreted primarily via the feces. This process removes excess iron from the body, reducing iron overload and its associated organ damage.
Pharmacokinetics
Absorption:
Bioavailability:
Approximately 70% (relative to intravenous dose); Jadenu granules bioavailability is ~116% relative to Exjade film-coated tablets.
Tmax:
2-4 hours
FoodEffect:
High-fat meal increases AUC by 104% and Cmax by 87%. A light meal does not significantly affect AUC. Should be taken on an empty stomach or with a light meal.
Distribution:
Vd:
14 L
ProteinBinding:
>99% (primarily to serum albumin)
CnssPenetration:
Limited
Elimination:
HalfLife:
8-16 hours
Clearance:
Not explicitly stated as a single rate, but primarily hepatic metabolism and biliary excretion.
ExcretionRoute:
Primarily fecal (84%), renal (8%)
Unchanged:
Not available (majority metabolized)
Pharmacodynamics
OnsetOfAction:
Iron chelation begins shortly after administration, but clinical effects (e.g., reduction in serum ferritin) are observed over weeks to months.
PeakEffect:
Reduction in iron burden is a gradual process, with peak therapeutic effect observed after several months of consistent therapy.
DurationOfAction:
Once daily dosing provides continuous chelation over 24 hours.
Safety & Warnings
BLACK BOX WARNING
Renal Impairment: Deferasirox can cause acute renal failure, and fatal outcomes have been reported. Monitor serum creatinine and urine protein monthly. Hepatic Impairment: Deferasirox can cause hepatic failure, and fatal outcomes have been reported. Monitor liver function tests monthly. Gastrointestinal Hemorrhage: Gastrointestinal hemorrhage, including fatal hemorrhage, has been reported. Monitor for signs and symptoms of GI bleeding.
Side Effects
Urgent Side Effects: Seek Medical Help Right Away
Although rare, some people may experience severe and potentially life-threatening side effects while taking this medication. If you notice any of the following symptoms, contact your doctor immediately or seek emergency medical attention:
Signs of an allergic reaction: rash, hives, itching, red, swollen, blistered, or peeling skin (with or without fever), wheezing, tightness in the chest or throat, difficulty breathing, swallowing, or talking, unusual hoarseness, or swelling of the mouth, face, lips, tongue, or throat.
Signs of kidney problems: inability to urinate, changes in urine output, blood in the urine, or significant weight gain.
Signs of liver problems: dark urine, fatigue, decreased appetite, stomach upset or pain, light-colored stools, vomiting, or yellow skin and eyes.
Signs of bowel problems: black, tarry, or bloody stools, fever, mucus in the stool, vomiting blood or coffee ground-like material, severe stomach pain, constipation, or diarrhea.
Changes in hearing or vision.
Chest pain or pressure, rapid heartbeat, or fainting.
Flu-like symptoms.
Rashes, which may require discontinuation of the medication. If you develop a rash, contact your doctor promptly to determine the best course of action.
Severe skin reactions, including Stevens-Johnson syndrome (SJS), toxic epidermal necrolysis (TEN), and other serious conditions, which can be life-threatening. Seek immediate medical attention if you experience red, swollen, blistered, or peeling skin; red or irritated eyes; sores in your mouth, throat, nose, eyes, genitals, or skin; fever; chills; body aches; shortness of breath; or swollen glands.
Decreased bone marrow function, which can lead to severe bleeding or infections. Contact your doctor right away if you experience signs of infection, such as fever, chills, severe sore throat, ear or sinus pain, cough, increased or discolored sputum, painful urination, mouth sores, or unhealing wounds; bruising or bleeding; or excessive fatigue or weakness.
Other Possible Side Effects
Like all medications, this drug can cause side effects, although not everyone will experience them. If you encounter any of the following side effects or any other symptoms that concern you or persist, contact your doctor:
* Diarrhea, stomach pain, upset stomach, or vomiting.
This is not an exhaustive list of potential side effects. If you have questions or concerns about side effects, consult your doctor. You can also report side effects to the FDA at 1-800-332-1088 or online at https://www.fda.gov/medwatch.
Although rare, some people may experience severe and potentially life-threatening side effects while taking this medication. If you notice any of the following symptoms, contact your doctor immediately or seek emergency medical attention:
Signs of an allergic reaction: rash, hives, itching, red, swollen, blistered, or peeling skin (with or without fever), wheezing, tightness in the chest or throat, difficulty breathing, swallowing, or talking, unusual hoarseness, or swelling of the mouth, face, lips, tongue, or throat.
Signs of kidney problems: inability to urinate, changes in urine output, blood in the urine, or significant weight gain.
Signs of liver problems: dark urine, fatigue, decreased appetite, stomach upset or pain, light-colored stools, vomiting, or yellow skin and eyes.
Signs of bowel problems: black, tarry, or bloody stools, fever, mucus in the stool, vomiting blood or coffee ground-like material, severe stomach pain, constipation, or diarrhea.
Changes in hearing or vision.
Chest pain or pressure, rapid heartbeat, or fainting.
Flu-like symptoms.
Rashes, which may require discontinuation of the medication. If you develop a rash, contact your doctor promptly to determine the best course of action.
Severe skin reactions, including Stevens-Johnson syndrome (SJS), toxic epidermal necrolysis (TEN), and other serious conditions, which can be life-threatening. Seek immediate medical attention if you experience red, swollen, blistered, or peeling skin; red or irritated eyes; sores in your mouth, throat, nose, eyes, genitals, or skin; fever; chills; body aches; shortness of breath; or swollen glands.
Decreased bone marrow function, which can lead to severe bleeding or infections. Contact your doctor right away if you experience signs of infection, such as fever, chills, severe sore throat, ear or sinus pain, cough, increased or discolored sputum, painful urination, mouth sores, or unhealing wounds; bruising or bleeding; or excessive fatigue or weakness.
Other Possible Side Effects
Like all medications, this drug can cause side effects, although not everyone will experience them. If you encounter any of the following side effects or any other symptoms that concern you or persist, contact your doctor:
* Diarrhea, stomach pain, upset stomach, or vomiting.
This is not an exhaustive list of potential side effects. If you have questions or concerns about side effects, consult your doctor. You can also report side effects to the FDA at 1-800-332-1088 or online at https://www.fda.gov/medwatch.
Seek Immediate Medical Attention If You Experience:
- Severe stomach pain, nausea, vomiting, or diarrhea
- Black, tarry, or bloody stools; vomiting blood (signs of GI bleeding)
- Yellowing of skin or eyes (jaundice)
- Dark urine or pale stools
- Unusual tiredness or weakness
- Swelling in your ankles or feet
- Decreased urination
- New or worsening skin rash
- Changes in hearing or vision (e.g., blurred vision, ringing in ears)
- Sudden, severe headache
Before Using This Medicine
Before Taking This Medication: Important Information to Share with Your Doctor
It is essential to inform your doctor about the following:
Any allergies you have, including allergies to this medication, its components, or other substances, such as foods or drugs. Be sure to describe the allergic reaction you experienced.
Certain health conditions, including:
+ Cancer
+ Blood or bone marrow disorders, such as low platelet count or high-risk myelodysplastic syndrome (MDS)
+ Kidney disease
+ Liver disease
Any instances of dehydration, such as:
+ Inability to eat or drink normally
+ Diarrhea
+ Vomiting
+ Other illnesses that may cause dehydration
Use of similar medications. If you are unsure, consult your doctor or pharmacist.
Concurrent use of the following medications:
+ Cholestyramine
+ Colesevelam
+ Colestipol
+ Phenobarbital
+ Phenytoin
+ Rifampicin
+ Ritonavir
+ Theophylline
+ Tizanidine
If you are breast-feeding. Note: You should not breast-feed while taking this medication.
This list is not exhaustive. It is crucial to discuss all your medications (prescription, over-the-counter, natural products, and vitamins) and health conditions with your doctor and pharmacist to ensure safe use of this medication. Do not initiate, discontinue, or modify the dosage of any medication without consulting your doctor.
It is essential to inform your doctor about the following:
Any allergies you have, including allergies to this medication, its components, or other substances, such as foods or drugs. Be sure to describe the allergic reaction you experienced.
Certain health conditions, including:
+ Cancer
+ Blood or bone marrow disorders, such as low platelet count or high-risk myelodysplastic syndrome (MDS)
+ Kidney disease
+ Liver disease
Any instances of dehydration, such as:
+ Inability to eat or drink normally
+ Diarrhea
+ Vomiting
+ Other illnesses that may cause dehydration
Use of similar medications. If you are unsure, consult your doctor or pharmacist.
Concurrent use of the following medications:
+ Cholestyramine
+ Colesevelam
+ Colestipol
+ Phenobarbital
+ Phenytoin
+ Rifampicin
+ Ritonavir
+ Theophylline
+ Tizanidine
If you are breast-feeding. Note: You should not breast-feed while taking this medication.
This list is not exhaustive. It is crucial to discuss all your medications (prescription, over-the-counter, natural products, and vitamins) and health conditions with your doctor and pharmacist to ensure safe use of this medication. Do not initiate, discontinue, or modify the dosage of any medication without consulting your doctor.
Precautions & Cautions
It is essential to inform all your healthcare providers, including doctors, nurses, pharmacists, and dentists, that you are taking this medication. Until you are familiar with how this drug affects you, avoid driving and other activities that require alertness.
To monitor your health, follow your doctor's instructions for regular blood work, lab tests, eye exams, and hearing tests. When taking this medication, do not use antacids containing aluminum.
If you are 55 years or older, use caution when taking this drug, as you may be more susceptible to side effects. Similarly, when administering this medication to a child, exercise caution, as the risk of certain side effects may be higher in pediatric patients. If your child's weight changes while taking this medication, consult your doctor, as their dose may need to be adjusted.
When using this medication, be aware that birth control pills and other hormone-based contraceptives may be less effective in preventing pregnancy. To minimize the risk of unplanned pregnancy, use an additional form of birth control, such as a condom, while taking this drug.
If you are pregnant or plan to become pregnant, inform your doctor, as they will need to discuss the potential benefits and risks of using this medication during pregnancy with you.
To monitor your health, follow your doctor's instructions for regular blood work, lab tests, eye exams, and hearing tests. When taking this medication, do not use antacids containing aluminum.
If you are 55 years or older, use caution when taking this drug, as you may be more susceptible to side effects. Similarly, when administering this medication to a child, exercise caution, as the risk of certain side effects may be higher in pediatric patients. If your child's weight changes while taking this medication, consult your doctor, as their dose may need to be adjusted.
When using this medication, be aware that birth control pills and other hormone-based contraceptives may be less effective in preventing pregnancy. To minimize the risk of unplanned pregnancy, use an additional form of birth control, such as a condom, while taking this drug.
If you are pregnant or plan to become pregnant, inform your doctor, as they will need to discuss the potential benefits and risks of using this medication during pregnancy with you.
Overdose Information
Overdose Symptoms:
- Nausea
- Vomiting
- Diarrhea
- Abdominal pain
- Headache
- Dizziness
- Fever
- Rash
- Elevated liver transaminases
- Renal dysfunction
What to Do:
Seek immediate medical attention. Call 911 or your local emergency number. For poison control, call 1-800-222-1222. Management is supportive, including gastric lavage and symptomatic treatment.
Drug Interactions
Contraindicated Interactions
- Aluminum-containing antacids (due to potential for increased deferasirox exposure and toxicity)
Major Interactions
- UGT inducers (e.g., rifampin, phenytoin, phenobarbital, ritonavir) - may decrease deferasirox exposure, requiring dose increase.
- CYP3A4 inducers (e.g., rifampin, phenytoin, carbamazepine, phenobarbital) - may decrease deferasirox exposure.
- Midazolam (CYP3A4 substrate) - deferasirox may decrease midazolam exposure.
- Repaglinide (CYP2C8 substrate) - deferasirox may increase repaglinide exposure, increasing risk of hypoglycemia.
- Oral contraceptives (hormonal) - deferasirox may decrease efficacy of hormonal contraceptives.
- Vitamin K antagonists (e.g., warfarin) - increased risk of bleeding.
Moderate Interactions
- Proton pump inhibitors (PPIs) - may increase deferasirox exposure (e.g., omeprazole).
- H2-receptor antagonists - may increase deferasirox exposure (e.g., ranitidine).
- Cholestyramine - may decrease deferasirox exposure.
- Drugs metabolized by CYP2C8 (e.g., pioglitazone, rosiglitazone) - deferasirox may increase exposure.
Minor Interactions
- Not specifically categorized as minor, but general caution with drugs that affect renal or hepatic function.
Monitoring
Baseline Monitoring
Serum ferritin
Rationale: To establish baseline iron burden and guide initial dosing.
Timing: Prior to initiation of therapy
Serum creatinine and estimated GFR
Rationale: To assess baseline renal function and guide dosing, as deferasirox is renally eliminated and can cause renal impairment.
Timing: Prior to initiation of therapy
Urinalysis (proteinuria)
Rationale: To assess baseline renal tubular function, as deferasirox can cause proteinuria.
Timing: Prior to initiation of therapy
Liver function tests (ALT, AST, bilirubin)
Rationale: To assess baseline hepatic function, as deferasirox is hepatically metabolized and can cause hepatic impairment.
Timing: Prior to initiation of therapy
Audiometry and ophthalmology examination
Rationale: To establish baseline for potential sensory organ toxicities.
Timing: Prior to initiation of therapy
Routine Monitoring
Serum ferritin
Frequency: Monthly
Target: Goal is typically <1000 ng/mL, but individualized based on patient and clinical goals.
Action Threshold: Increase dose if ferritin >2500 ng/mL and well-tolerated; decrease dose if ferritin <500 ng/mL or rapidly declining.
Serum creatinine and estimated GFR
Frequency: Monthly
Target: Within normal limits for age.
Action Threshold: If serum creatinine increases by >33% above baseline on two consecutive measurements, or above age-appropriate upper limit of normal, consider dose reduction or interruption. If >2 times age-appropriate upper limit of normal, interrupt therapy.
Urinalysis (proteinuria)
Frequency: Monthly
Target: Negative or trace protein.
Action Threshold: If persistent or increasing proteinuria, consider dose reduction or interruption and further renal evaluation.
Liver function tests (ALT, AST, bilirubin)
Frequency: Every 2 weeks for the first month, then monthly thereafter.
Target: Within normal limits.
Action Threshold: If transaminases increase >5 times upper limit of normal, or >3 times upper limit of normal with bilirubin >2 times upper limit of normal, interrupt therapy. Re-evaluate for other causes.
Audiometry and ophthalmology examination
Frequency: Annually
Target: Stable hearing and vision.
Action Threshold: If new or worsening hearing loss or visual disturbances, consider dose reduction or interruption and specialist referral.
Symptom Monitoring
- Signs of renal impairment (e.g., decreased urine output, swelling, fatigue)
- Signs of hepatic impairment (e.g., jaundice, dark urine, abdominal pain, nausea, vomiting)
- Gastrointestinal symptoms (e.g., abdominal pain, nausea, vomiting, diarrhea, constipation)
- Skin rash
- Hearing changes (e.g., ringing in ears, decreased hearing)
- Vision changes (e.g., blurred vision, decreased vision)
- Bleeding (e.g., black or bloody stools, vomiting blood)
Special Patient Groups
Pregnancy
Deferasirox may cause fetal harm when administered to a pregnant woman. Animal studies have shown adverse developmental effects. Use during pregnancy only if the potential benefit justifies the potential risk to the fetus.
Trimester-Specific Risks:
First Trimester:
Potential for teratogenicity based on animal data.
Second Trimester:
Potential for adverse developmental effects.
Third Trimester:
Potential for adverse developmental effects.
Lactation
It is unknown if deferasirox is excreted in human milk. Due to the potential for serious adverse reactions in the breastfed infant, a decision should be made whether to discontinue nursing or to discontinue the drug, taking into account the importance of the drug to the mother.
Infant Risk:
Risk unknown, but potential for serious adverse effects. Advise caution.
Pediatric Use
Approved for transfusional iron overload in patients âĨ2 years old and for NTDT in patients âĨ10 years old. Close monitoring of growth, weight, and development is recommended. Renal and hepatic function should be monitored closely, as pediatric patients may be more susceptible to adverse effects.
Geriatric Use
Increased incidence of adverse reactions, including renal impairment, gastrointestinal hemorrhage, and myelosuppression, has been observed in elderly patients. Use with caution and monitor closely, especially for renal and hepatic function.
Clinical Information
Clinical Pearls
- Deferasirox granules must be sprinkled on soft food (e.g., applesauce, yogurt) and consumed immediately. Do not chew or swallow whole.
- Take on an empty stomach or with a light meal to optimize absorption and minimize GI side effects.
- Consistent daily administration is key for effective iron chelation.
- Strict adherence to monitoring protocols (ferritin, renal, hepatic, auditory, ophthalmic) is critical due to potential serious adverse effects.
- Patients should be educated on signs of renal, hepatic, and GI toxicity and instructed to report them immediately.
- Hydration is important during therapy to support renal function.
Alternative Therapies
- Deferoxamine (Desferal) - parenteral iron chelator
- Deferiprone (Ferriprox) - oral iron chelator, often used in combination with deferasirox or deferoxamine for severe iron overload (combination therapy is off-label for deferasirox in some regions/indications).
Cost & Coverage
Average Cost:
Highly variable, typically several thousand USD per 30-day supply
Generic Available:
Yes
Insurance Coverage:
Tier 4 (Specialty Drug) or higher, often requiring prior authorization and step therapy.
General Drug Facts
If your symptoms or health issues persist or worsen, it's essential to contact your doctor for further guidance. To ensure your safety, never share your medication with others or take someone else's medication.
This medication is accompanied by a Medication Guide, which provides crucial information about its use. Please read this guide carefully and review it again whenever you receive a refill. If you have any questions or concerns about this medication, don't hesitate to consult with your doctor, pharmacist, or other healthcare provider.
In the event of a suspected overdose, immediately call your local poison control center or seek emergency medical attention. Be prepared to provide detailed information about the overdose, including the medication taken, the amount, and the time it occurred.
This medication is accompanied by a Medication Guide, which provides crucial information about its use. Please read this guide carefully and review it again whenever you receive a refill. If you have any questions or concerns about this medication, don't hesitate to consult with your doctor, pharmacist, or other healthcare provider.
In the event of a suspected overdose, immediately call your local poison control center or seek emergency medical attention. Be prepared to provide detailed information about the overdose, including the medication taken, the amount, and the time it occurred.